Healthcare Provider Details

I. General information

NPI: 1962325977
Provider Name (Legal Business Name): MADISON MUHA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 WOODWORTH LN
SCITUATE MA
02066-4439
US

IV. Provider business mailing address

10 WOODWORTH LN
SCITUATE MA
02066-4439
US

V. Phone/Fax

Practice location:
  • Phone: 781-987-4344
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN2355149
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: